Agenda and minutes

The Chairman and Committee thanked the Overview, Scrutiny and Localism Manager for all his hard work since the creation of HOSC and wished him well in his new role within a different part of Kent County Council.

RESOLVED that the Minutes of the Meeting of 4 February 2011 are recorded and that they be signed by the Chairman.

(1)       The Chairman introduced the item and explained that, in connection to this issue, it was a positive sign that the work of Kent County Council and the county’s MPs had delivered a way forward on improving the A21.

(2)       One Member expressed the view that the popularity of the new Pembury Hospital was also a positive sign.

(3)       RESOLVED that the Committee note the attached correspondence.

(1)       The general principles behind the idea of establishing informal groups were generally approved by the majority of Members of the Committee. A number of potential issues were raised as to how these would work with locality boards, Borough and District Councils as well as Town and Parish Councils and the developing GP Commissioning Consortia. More broadly the point was made that with so much change going on the health economy, there was a danger in establishing structures which would soon need to be changed.

(2)       Specifically the point was made that small groups tasked with exploring a particular issue, rather than broadly liaising with a Trust could add more value.

(3)       From the perspective of LINks, the question was raised as to how the proposed groups would work with LINk, particularly as LINks worked with Canterbury Christ Church University in producing comments for provider Trust Quality Accounts. The offer was made to share this work with the Committee.

(4)       The Chairman agreed that many valid points were raised and stated that a refreshed paper would be presented to the Committee at the following meeting of the Committee.

(1)       One Member expressed the view that the consensus on the proposals seemed to be that reduction in the number of specialist centres was necessary, but that the real issue was which ones would be the ones to close.

(2)       RESOLVED that the Committee agree that a regional response to the consultation be agreed through the South East Coast HOSC Chairman network.

Bill Jones (Interim Director of Finance, NHS Eastern and Coastal Kent), Dr Mike Parks (Medical Secretary, Kent Local Medical Committee), Daryl Robertson (Deputy Chief Executive, NHS West Kent) and Di Tyas (Deputy Clerk, Kent Local Medical Committee) were in attendance for this item.

(1)       The Chairman introduced the first of three meetings on the topic of NHS Financial Sustainability by giving his view that the question was not about the overall level of Government funding to the NHS, but rather the issues of whether Kent was receiving its fair share and how resources were prioritised locally. The intention was for the Committee to produce recommendations at the end of the three meetings and suggestions were invited from Members.

(2)       One of the key issues discussed was that of legacy debt, where there was the risk that GP Commissioning Consortia (GPCC) may take over full commissioning responsibility from Primary Care Trusts (PCTs) in 2013 with inherited debt. One Member explained how this had been an issue in the past when PCTs were established and reorganised and that there was an argument for saying that this had proved a distraction from improving local health services. Another Member explained how there needed to be an awareness of the different kinds of legacy debt, including straightforward overspends from the previous financial year, as well as ongoing commitments.

(3)       Representatives from the NHS explained that both PCTs in Kent were going to break even at the end of this financial year, and that current spending information was available after two weeks so that commissioners were not in a position where spending was authorised after the budget had already been allocated.

(4)       Colleagues from the NHS indicated the clear summary of the PCT allocation formula available in the Agenda and summarised even further by explaining that it was larger based on population, with an element of weighting around deprivation. Concern was expressed by Members about the level of detail the allocation formula went into and whether it went into sufficient detail to pick up the pockets of severe deprivation that existed across Kent. The offer was made to provide further details on the per capita funding and the formula itself.

(5)       There was also sometimes a difference between a PCT’s actual allocation and its target allocation, but both Kent PCTs were on target. There was some discussion about the actual per capita allocation for Kent. In terms of the demographic challenge in future health funding, that of ageing was highlighted as significant in that people aged under 50 consumed relatively few health resources, and most were used in the last two years of a person’s life.

(6)       A question was asked about the additional funding of £16 million made available to the PCTs to support social services and it was explained that the NHS and Kent County Council had already agreed on how this would best be used.

(7)       Details were requested around the £2 per head allocated to support the development of GPCC.  ...  view the full minutes text for item 7.